Home-based Child Care Research Articles

Parents spend an average of nine hours a day providing palliative care for children at home and need to maintain an average of five life-saving devices.

This Italian study investigated home-based palliative care for young children and how long it took parents to meet their needs. The study population consisted of 33 families with a child under the responsibility of the Veneto Regional Center for Pediatric Palliative Care, northern Italy, who needed medical support in at least two of the following areas: respiratory, feeding, pain and seizures. The children had a mean age of 6.8 ± 4.7 years. We found that 72% of the patients needed medical devices for feeding, 36% had a tracheostomy and 55% were on mechanical ventilatory support. The children needed an average of five different life-supporting medical appliances, and the time taken to provide for their care increased significantly with each additional appliance (p = 0.016). Their most time-consuming daily needs were feeding (174 minutes) and support when they woke up at night (67 minutes). The average daily time that parents spent taking care of their child amounted to eight hours and 54 minutes per day. Parents providing palliative care for children with life-limiting diseases spent an average of nine hours a day caring for them each day and had to maintain an average of five medical appliances.

Family, Friend, and Neighbor Care: Crib Notes on a Complex Issue

Before the 1996 federal welfare reform, home-based childcare was either overlooked or looked down upon. Since then, there has been a flurry of research investigating kith and kin childcare - which makes up approximately 73% of child care in the U.S. This essay provides insight into who provides home-based care and the quality of that care.

Experiences and needs of home-based childcare center directors regarding onsite visit consulting for accreditation

본 연구는 가정어린이집 원장의 평가인증 현장방문 컨설팅에 대한 어려움과 개선에 대한 요구를 살펴보고 이해함으로써 가정어린이집의 질적 향상을 위한 평가인증 현장방문 컨설팅의 지원방향을 모색하기 위한 것이다. 이를 위해 평가인증 현장방문 컨설팅을 경험한 가정어린이집 원장 9명을 대상으로 개별심층면담을 실시하였다. 연구결과 첫째, 가정어린이집 원장은 평가인증 준비를 위한 외부교육 참여의 한계와 지표의 혼란으로 인한 자체적 노력의 한계, 익숙함에서 오는 재확인과정의 한계로 인해 컨설팅을 신청하고자 하였다. 둘째, 가정어린이집 원장은 컨설팅이 보육시간에 협소한 장소에서 이루어지는 것에 대한 어려움을 느꼈으며, 교사겸직원장역할 수행으로 인한 어려움, 컨설턴트의 역량과 자질의 차이에서 오는 어려움을 경험하였다. 셋째, 가정어린이집 원장은 제도적 개선으로 보조(대체)인력 지원, 교사와 영아 간의 상호작용 컨설팅, 가정어린이집의 특성을 잘 이해하고 있는 컨설턴트 파견을 요구하였다. 본 연구는 가정어린이집 평가인증 현장방문 컨설팅의 개선점을 파악할 수 있는 기회를 제공하고, 어린이집 시설 유형을 반영한 평가인증 컨설팅 프로그램 개발의 필요성과 방향을 제시하였다는데 의미가 있다.This study is to understand the experiences of home-based childcare center directors who have experienced onsite visit consulting for accreditation. The study eventually aims to improve quality of home-based childcare by seeking for better ways to support onsite consulting. To this end, individual in-depth interviews were conducted with 9 home-based childcare center directors who experienced onsite visit consulting for accreditation. The findings of the study are as follows. First, the directors participated into the onsite visit consulting due to limited chance of participating into off-site training to prepare for accreditation, confusion of the indicators, and the excessive familiarity of the accreditation process. Second, the directors faced difficulties in the onsite visit consulting process because the consulting was conducted in a confined space during working hours. There were also difficulties in performing the role of both director and teacher, as well as in the various qualifications of the consultants. Third, the directors demanded support for assisting (substitute) staff, more focused consulting on interaction between teachers and children, and consultants who understand the characteristics of home-based childcare centers well.

The experiences of caregivers of children living with HIV and AIDS in Uganda: a qualitative study

BackgroundHome-based care for HIV patients is popular in contexts severely affected by the epidemic and exacts a heavy toll on caregivers. This study aimed at understanding the experiences of caregivers and their survival strategies.MethodsA total of 18 caregivers (3 males and 15 females) were interviewed using a semi-structured interview guide, and thematic analysis was used to analyse the data.ResultsAnalysis suggests that the caregivers are burdened with insecure provisions for food and difficulties in accessing health care. They however survived these strains through managing their relationships, sharing burden with care-recipients, social networks and instrumental spirituality. These findings are discussed under two major themes: 1). Labour of caregiving and 2). Survivalism.ConclusionsHome-based care presents huge opportunities for community response to the HIV/AIDS epidemic in African settings. It is however burdensome and thus should not be left for families alone to shoulder. There is therefore an urgent need for protecting home-based care for HIV children in Uganda. Implications for improving and strengthening social interventions in home-based care of HIV/AIDS in the Ugandan context are addressed.

Understanding and Incorporating Home-Based Child Care Into Early Education and Development Systems

Millions of families across the United States rely on home-based child care—noncustodial care in home-based settings—while they work or attend school. Indeed, home-based child care is the most prev...

Home-Based Child Care Provider Education and Specialized Training: Associations With Caregiving Quality and Toddler Social-Emotional and Cognitive Outcomes

ABSTRACTResearch Findings: Although there has been considerable research on the associations between the qualifications of teachers in center-based settings and preschool-age children’s developmental outcomes, very little is known about the relationships between home provider qualifications and the developmental outcomes of toddlers who attend licensed family child care settings or unregulated family, friend, and neighbor care settings. Analyzing a sample of toddlers and their providers drawn from the Early Childhood Longitudinal Study, Birth Cohort, we found positive relationships between home-based quality and higher education degree (defined as an associate’s degree or at least a bachelor’s degree), field of major, and coursework in early childhood education or a related field. However, provider qualifications were unrelated to children’s cognitive outcomes and related to a limited number of social-emotional outcomes. Practice or Policy: Our results suggest that as states consider the spectrum of supports needed for strengthening home-based child care in ways that facilitate responsive and developmentally supportive caregiving, strategies should include opportunities for home-based care providers to pursue higher education. A more nuanced analysis of the content and comprehensiveness of providers’ formal education is needed to better understand relationships between toddlers’ social and cognitive development and providers’ formal education.

Observed differences in child picky eating behavior between home and childcare locations

Picky eating (PE) is a common mealtime difficulty that is reported by up to 50% of caregivers. Most of the research to date on PE has focused on parents, even though millions of children also eat meals in home- or center-based childcare settings. Currently, little is known about PE behaviors manifested by the child across the home and childcare settings, or how these behaviors differ between home-based childcare (HBCC) and center-based childcare (CBCC) locations. The objectives of this study were to compare PE behaviors between the child's home and HBCC or CBCC environments, and compare PE behaviors between HBCC and CBCC environments. Children, ages 3–5 years, were recruited from CBCC (n = 26) or HBCC (n = 24) locations. Caregivers and children were videotaped consuming two different lunchtime meals in their home and childcare. Picky eating behaviors were coded from the videos using a codebook created for the study. Observational results showed that children in CBCC displayed more PE behaviors when at home than at childcare, while HBCC children displayed PE behaviors more similarly between the two locations. Thus, interventions to reduce PE behaviors should be personalized for location-specific intervention programs focused on raising healthy eaters across multiple locations.

Providing Opportunities to Learn in Home-Based Child Care Settings: Observations of Learning Contexts and Behavior

ABSTRACTResearch Findings: This observation study investigated the prevalence and correlates of learning contexts provided to preschool-age children in 133 registered child care homes in below-average-income neighborhoods in the U.S. Pacific Northwest. On average, 30% of the observed proportion of time was spent in structured teacher-led activities, 51% in free-choice activities, 10% in routine activities, 1% in watching video/TV, and 7% in transition. Home-based child care providers gave significantly more positive recognition during structured teacher-led activities, and children engaged in more prosocial behavior during free-choice time. Directives and noncompliance occurred more often during transitions. A higher child-to-caregiver ratio was associated with more time spent in free-choice time, and caregiver experience and education were not associated with the time spent in specific learning contexts. Practice or Policy: Similar to preschool and center-based child care, current practice in home-based child care is to offer a mix of structured teacher-led and free-choice activities. To facilitate young children’s skill development within these learning activities typically offered, it is necessary to increase research and provide empirically based professional development opportunities relevant to home-based child care settings. Attention to home-based child care will likely reach many young children and be particularly beneficial for those in low-income households.

Differences and Agreement in Perception of Child Picky Eating Among Center- and Home-Based Childcare Providers and Parents and Its Impact on Utilized Mealtime Strategies.

Picky eating is a problematic eating behavior caregivers may encounter with children under their care. A picky eater (PE) is typically characterized as consuming a narrow range of food, as well as rejecting several food items. Much of the literature regarding PEs involves parents, although use of nonparental childcare arrangements in the United States has increased in the past several decades. Although data on parental mealtime strategies exist, little is known about how parent and childcare provider pickiness perceptions differ between types of childcare, such as center-based childcare (CBCC) and home-based childcare (HBCC), or how these perceptions influence the mealtime strategies utilized. The objectives of this study were to (1) compare perceptions of child pickiness between parents and childcare providers, (2) compare percent agreement in pickiness perception between the dyads of CBCC parents and providers and HBCC parents and providers, and (3) identify mealtime strategy utilization based on pickiness perception. A total of 52 child, parent, and childcare provider triads participated in the study and completed the Mealtime Assessment Survey and the Parent/Teacher Mealtime Strategy Survey regarding the same child. Results showed that parents are 1.4 times more likely than childcare providers to perceive a child as being picky, HBCC parents and providers are 1.4 times more likely to perceive a child as being picky than CBCC parents and providers, CBCC parents and providers disagree more in their perception of child pickiness than HBCC parents and providers (41% vs 26%), and finally, perception of child pickiness has a greater influence on mealtime strategies utilized by parents. These results can be used to focus intervention efforts aimed at improving child eating habits across the home and childcare location.

Providing High-Quality Support Services to Home-Based Child Care: A Conceptual Model and Literature Review

ABSTRACTResearch Findings: Home-based child care accounts for a significant proportion of nonparental child care arrangements for young children in the United States. Yet the early care and education field lacks clear models or pathways for how to improve quality in these settings. The conceptual model presented here articulates the components of high-quality support to child care providers; related factors; and hypothesized provider, family, and child outcomes. The model is based on a literature review of research on home-based child care, home visiting, early childhood mental health consultation, coaching, and family services. We hypothesize that high-quality support to home-based child care that offers relationship-based services focused on quality caregiving (individual home visiting and group supports such as training and networking) and sustainability (materials, equipment, referrals) is most likely to positively impact quality caregiving for children and families. Practice or Policy: Current federal efforts and policy initiatives to increase the supply and quality of infant–toddler child care focus on the development of systems that support home-based providers. The conceptual model of high-quality support described here will inform future program development and research on how to improve quality in home-based child care for the millions of low-income children in these settings.

Ecomapping as a Research Tool for Informal Child Care

ABSTRACTResearch Findings: Many young children spend crucial developmental years in informal, home-based child care (HBCC) settings, but parents and others share concerns about HBCC quality. We applied the ecomap method in a descriptive study of racially, ethnically, and linguistically diverse informal caregivers and parents to capture their informal caregiving arrangements, social networks, and social supports. For the parents in our study, informal child care was a flexible, affordable, and readily accessible child care option. For caregivers, informal care provided opportunities to help family and friends and to earn extra income. Social networks were characterized largely by relationships with family and friends, and social supports tended to be strong and mutually beneficial. Practice or Policy: We found that ecomapping is an engaging and flexible method of capturing and understanding complex child care arrangements and social networks in HBCC settings. As a research tool, ecomapping can help improve the quality of care in informal settings by identifying and meeting the needs of parents and HBCC providers and informing program development and delivery strategies.

Supporting family child care and quality improvement: findings from an exploratory survey of Illinois child care resource and referral agency staff

Improved quality in home-based child care (family child care and family, friend, and neighbor care) is increasingly recognized as a vital component of early care and education service systems in the U.S. and abroad and is a target of recent federal and state policy initiatives in the U.S. This article presents data from a statewide survey of 73 child care resource and referral specialists across Illinois who work with family child care providers on a regular basis through home visiting, training, and technical assistance. Descriptive findings suggest that specialists who work with family child care providers perform a unique role in the early care and education field. The study examines job roles, common challenges and rewards, and needs for training. Specialists’ training needs include understanding the unique context of family child care, home visiting, coaching, and working with families. Understanding the training and professional development needs of support staff as well as the challenges faced in carrying out this work has the potential to inform state professional development systems as well as other initiatives aimed at improving quality in this sector of the early care and education workforce.

Nature and Structure of Temperament in Early and Middle Childhood: A Multi-Method Approach

Picky eating (PE) is a common mealtime difficulty that is reported by up to 50% of caregivers. Most of the research to date on PE has focused on parents, even though millions of children also eat meals in home- or center-based childcare settings. Currently, little is known about PE behaviors manifested by the child across the home and childcare settings, or how these behaviors differ between home-based childcare (HBCC) and center-based childcare (CBCC) locations. The objectives of this study were to compare PE behaviors between the child's home and HBCC or CBCC environments, and compare PE behaviors between HBCC and CBCC environments. Children, ages 3–5 years, were recruited from CBCC (n = 26) or HBCC (n = 24) locations. Caregivers and children were videotaped consuming two different lunchtime meals in their home and childcare. Picky eating behaviors were coded from the videos using a codebook created for the study. Observational results showed that children in CBCC displayed more PE behaviors when at home than at childcare, while HBCC children displayed PE behaviors more similarly between the two locations. Thus, interventions to reduce PE behaviors should be personalized for location-specific intervention programs focused on raising healthy eaters across multiple locations.

Observed Differences in Child Picky Eating Behaviors Between the Child's Home and Center‐ or Home‐based Childcare

Picky eating (PE), which typically defined as having low dietary variety and rejecting new and familiar foods, is a commonly reported problematic eating behavior that emerges during early childhood. PE causes parental concern and has been linked to lack of dietary variety and increased risk of depression, underweight, and developing an eating disorder in the child. Traditionally, parents have been primarily responsible for determining their child's dietary intake. However, the number of children placed in non‐parental, i.e., center‐based childcare (CBC) or home‐based childcare (HBC), has risen substantially, increasing care providers’ influence on the development of children's eating behaviors. Currently little is known about PE behaviors manifested by the child across the home and childcare settings. Furthermore, most research in the area of early childcare focuses on CBC, although 15% of children in non‐parental childcare are cared for in HBC. Therefore, the objective of this research was to investigate observed child PE behaviors across settings, while controlling for the food provided to the child in each setting. Children, ages 3–5 years, were recruited from a CBC (n=26) or HBC (n=24) childcare locations in the Champaign‐Urbana area. Children were videotaped consuming two different lunchtime meals in both their home and childcare for a total of 200 observed mealtimes. Physical and verbal food refusals and avoidances were coded from the videos as PE behaviors. Inter‐rater reliability of Cohen's Kappa >0.90 was achieved for all coders. The McNemar test results revealed that children in CBC expressed all PE behaviors more often at home than at childcare (P<0.0001). Children in HBC expressed more physical refusals and verbal avoidances at home compared to their childcare location (P<0.0001). However, there was no significant difference in the number of verbal refusals between home and HBC and significantly more physical avoidances at HBC than home (P<0.001). Thus, children were observed to respond differently to the same foods based on the mealtime location, and, overall, expressed more PE behaviors at home than in either childcare setting. The findings from this study add to the knowledge base of child eating behaviors and can be used to create specialized, location‐specific intervention and education programs with the goal of raising healthy, independent eaters.Support or Funding InformationChristopher Family Foundation Food and Family Program.

Additional Evidence to help Inform Illinois Child Care System

This presentation by Rachel Gordon to the Commission to Reform Child Care in Illinois (est. by HR 0254) examines studies of child care centers. The first study regarded funding delays from the state in 2011-2012. In a comprehensive survey through the Chicago Area Study, the researchers interviewed child-care center directors on the west and north sides of Chicago. They focused on child care providers’ experiences with the great recession and the state budget crisis, and especially disparities in experiences across communities. In another representative national ECLS-B study of children's early care arrangements and their emerging reading and math skills, the researchers examined parent preferences and child development when parents combined center- and home- based care. About 20% of 4-year-olds attended both home- and center-based child care. Based on parents’ reports about reasons for choosing care, families who combined home and center care appeared to be meeting their priorities, both for getting their child ready for school and having a familiar caregiver who shared their background and beliefs. The results offer preliminary evidence that the benefits to academic readiness of attending preschool might be achieved when children combine half-day center-based experiences with part-day home-based child care. We encourage more research on how and why parents combine part-time preschool with home-based arrangements, and children's experiences in both of these settings.

A Review of the Research on Childminding: Understanding Children\u2019s Experiences in Home-Based Childcare Settings

This paper offers a discussion of the literature of an under-developed area of early years research—the exploration of childminding or home-based childcare and the contribution which this form of provision makes for children and families. Despite growing interest in childminding at the policy level and some international research on understanding home-based childcare settings and practices, there remains a relative dearth of studies conceptualising and reviewing the extant literature. This paper addresses this gap by presenting the findings of a comprehensive database search for literature and a review of published international work from 1990 to 2013. It offers a conceptual analysis of the notion of “home-based childcare”, with a focus on understanding caregivers’ practices, and the key issues and debates that characterise the field. The paper argues that home-based childcare not only offers a specialist type of service as family support, especially for vulnerable families, but that it provides a form of pedagogical approach to children’s developmental and educational outcomes that is distinct from any other types of early years care.

Randomized Video-Feedback Intervention in Home-Based Childcare: Improvement of Children's Wellbeing Dependent on Time Spent with Trusted Caregiver.

BackgroundThe childcare environment offers a wide array of developmental opportunities for children. Providing children with a feeling of security to explore this environment is one of the most fundamental goals of childcare.ObjectiveIn the current study the effectiveness of Video-feedback Intervention to promote Positive Parenting-Child Care (VIPP-CC) was tested on children’s wellbeing in home-based childcare in a randomized controlled trial.MethodsForty-seven children and their caregivers were randomly assigned to the intervention group or control group. Children’s wellbeing, caregiver sensitivity, and global childcare quality were observed during a pretest and a posttest.ResultsWe did not find an overall intervention effect on child wellbeing, but a significant interaction effect with months spent with a trusted caregiver was present. Children who were less familiar with the caregiver showed an increase in wellbeing scores in both the intervention and control group, but for the group of children who were more familiar with the caregiver, wellbeing increased only in the intervention group.ConclusionsAlthough there was no overall effect of the VIPP-CC on children’s wellbeing, the VIPP-CC seems effective in children who have been cared for by the same trusted caregiver for a longer period of time.

『子どもと家族を主体としたケア』に関する看護師の認識の特徴:—医療的ケアを必要とする子どもの在宅ケアを検討してから家庭で生活する時期に焦点を当てて—

『子どもと家族を主体としたケア』に関する看護師の認識の特徴:—医療的ケアを必要とする子どもの在宅ケアを検討してから家庭で生活する時期に焦点を当てて—

Quality in Home-Based Child Care for Under-Two-Year Old Children in Aotearoa New Zealand: Conceptualising Quality from Stakeholder Perspectives

Recent policy reports have raised concerns about quality education and care for under 2-year-olds attending home-based early childhood and care (HBEC) services, an issue that has received minimal research attention in Aotearoa New Zealand. This article explores what is meant by “quality” in HBEC for children under two using an ecological framework, drawing on the perspectives of various stakeholders, outlining implications for future policy and practice. Four semi-structured focus group interviews elicited stakeholders’ views of quality. The four groups were: experts; service providers/visiting teachers; educators/nannies; parents/whānau. The participants identified key aspects of the roles, relationships and activities of the different actors within quality HBEC microsystems, as well as the critical importance of mesosystem connections. Relationships at all levels were identified as a key component of quality, supporting a principle underpinning the philosophy and framework of Te Whāriki.

Prevalence and influences of preschoolers' sedentary behaviors in early learning centers: a cross-sectional study.

BackgroundRecent research has highlighted the need for increased evidence regarding the sedentary activity levels of preschoolers. Given the large proportion of time this population spends in various early learning facilities, the exploration of sedentary behaviors within this particular environment should be a priority. The purpose of the study was two-fold: (1) to compare sedentary time of preschoolers in three different early learning environments (i.e., full-day kindergarten [FDK], center-, and home-based childcare); and (2) to assess which characteristics (i.e., staff behaviors, sedentary environment, fixed play environment, portable play environment, sedentary opportunities) of these early learning environments influence preschoolers’ sedentary time.MethodsData collection occurred between September 2011 and June 2012. Preschoolers’ sedentary time was measured using Actical™ accelerometers at a 15 s epoch. The Environment and Policy Assessment and Observation (EPAO) tool was used to assess the sedentary environment of participating early learning classrooms, and those subscales (n = 5) that were evidence-informed as potentially influencing sedentary time in early learning centers were explored in the current study. A linear mixed model ANCOVA was carried out to determine the differences in sedentary time based on type of early learning environment while direct entry regression analyses were performed to describe the relationships between sedentary time and the five sedentary-specific EPAO subscale.ResultsPreschoolers (n = 218) from 28 early learning programs (i.e., 8 FDK, 9 centre-, and 8 home-based childcare facilities) participated. Accelerometry data revealed that preschoolers attending centre-based childcare engaged in the highest rate of sedentary time (41.62 mins/hr, SD = 3.78) compared to preschoolers in home-based childcare (40.72 mins/hr, SD = 6.34) and FDK (39.68 mins/hr, SD = 3.43). The models for FDK, center-based childcare, and home-based childcare, comprised each of the five EPAO subscales accounted for 10.5 %, 5.9 %, and 40.78 % of the variability in sedentary time, respectively. Only the models for FDK and home-based childcare were found to be statistically significant (p < .05).ConclusionsThis is the first exploration of differences in sedentary time among preschoolers in different early learning arrangements. Findings highlight the substantial portion of the day preschoolers spend in sedentary pursuits, and subsequently, the ongoing need to reduce preschoolers’ sedentary time in early learning programs, particularly among those attending centre-based childcare facilities.